Thank you for paying
online! Please note that a $2.00 service fee applies for
online payments.

All
fields on this form are required for processing.

Billing Information

Your Property ID
Number
Your account number is required and
must be accurate to get credit for
your payment.
Please enter carefully.

Funds
will not be properly applied without
this description information.

Enter Your Property ID Number
Example: R12345 (R,M,P,N)
You may enter up to 10 Property IDs, one per line. Then add
the payments and enter the Total of all payments in
the Amount box below.

Name of Property Owner

Property Address

Property City

Property Zip Code

Phone Number

E-mailYour payment confirmation will go to this address.
You must have a working
email address to receive a payment confirmation!

Enter email address.

Check Payment Information

Name On
Check Enter your name as it appears
on the check.

Address Address where your statements
are received.

City

State

Zip Code

(5 digit zip only)

Bank Routing Number

(9 digit code on check)

Account Number

Check Number

Account Type

Individual or Business?

Payment Information

Amount of Payment

$
(Numbers only. No $ sign or commas!)If paying for more than one property,
enter the TOTAL of
the payment you are making.

Service
Fees Apply - a $2.00 Service Fee will
be added to your Payment Amount.
The
total shown below includes the service fee indicated. Service
fees are added by Gov-Pay, a 3rd-Party facilitator for government
payments and will appear as a charge
by Gov-Pay on your statement. By
checking the box beneath the total, you acknowledge and approve
the service fee charge.